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HomeMy WebLinkAboutHelath & Human Services Board 08-27-98ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD August 27, 1998 The St. Croix County Health and Human Services Board met on August 27. 1998. at the St. Croix County Health and Human Services/Health Center complex. MEMBERS PRESENT: Robert Stephens, Chair Leon Berenschot Chris Bethke Jack Dowd Einar Horne Fern Johnson Allen Limberg Mary Louise Olson George Sinclear MEMBERS ABSENT: None STAFF PRESENT: John Borup, Health and Human Services Director Judy Ziegler, Accountant Carolyn Krieger, Nursing Home Administrator Ron Lockwood, Long Term Support Marilyn Fruit, Economic Support Supervisor June Merkt, Home Health Supervisor Barbara Nelson, Public Health Supervisor Ron Eichstaedt, Workshop Director Ron Kiesler, Mental Health/AODA Coordinator Steve Kirt, MH/AODA Clinical Services Supervisor Fred Johnson, Family & Children's Supervisor Kathy Dunlap, Family & Children's Supervisor Norma Vrieze, Early Intervention Supervisor Dave Best, Maintenance Judy Aronson, Secretary OTHERS PRESENT: Ray Mealev Chair Stephens, called the meeting to order at 6:30 P.M. noting the meeting was properly and legally publicized. -ANNOUNCEMENTS: Borup stated the 1998 Annual Foster and Respite Parent Banquet is Friday, September 18, 1998, at 7:00 p.m. at the St. Croix National Golf Club, 1603 Countv Road V, Somerset, Wl. Banquet tickets are S15.00 each. NEXT MEETING: The next Health and Human Services Board meeting is scheduled for Friday, September 11. 1998 at 8:00 A.M. at the St. Croix County Health and Human Services/Health Center complex. Dowd will review vouchers at 7:30 a.m. AGENDA: MOTION: A motion was introduced by Bethke. seconded by Johnson, and unanimously adopted: That the agenda be approved as circulated. MINUTES: MOTION: A motion was introduced by Berenschot, seconded by Bethke, and unanimously adopted: That the minutes of the 08/11/98 Health and Human Services Board meeting be approved as circulated with the following change: Under HEALTH AND HUMAN SERVICES REPORTS, Page 7, paragraph 2, first sentence, insert the word "employee". The sentence would read, Krieger gave a report to the Board regarding the employee turnover rate of the Nursing Home compared to other nursing homes statewide. Presentation and Action on 1999 Budget for Health and Human Services and Nursing Home: Borup stated the budget is presented without an increase in County costs for Health and Human Services and zero County cost for the Nursing Home. The 1999 Budget applies $468.435 in `prior year carryover' funds. This does include $151,644 in `capital outlay' expenses, e.g. bus garage, workshop air conditioning, blacktop repair, etc. It also includes $139,264 for carpet, furniture, computers, etc. Also included is $8,000 for lease/purchase of one bussette for the workshop and is included in the workshop budget. Subtracting these expenses reduces the prior year carryover to $181,927. $70,000 is included to contract foster care recruitment, retention, and training and $50,000 for a mental health resource center. Salary and fringe benefits are the other major cost increase. Mental Health/AODA contract reductions (reduced beds) are noted along with increased Federal waiver money for Long Term Support programs. Borup detailed the capital outlay totaling $151,644. No funds are transferred from the Home Health account. 58.260 taken from Farm account to upgrade telephone call accounting system that is not Y2K compatible. Borup stated this budget is built with some revenue uncertainty, as Federal cuts are possible in 1999 that s. Medicare uncertainty could significantly impact the could be passed on to State and County government Nursing Home and Home Health programs. Medical Assistance deficit reduction dollars are very uncertain and impossible to predict. W-2 profits remain elusive, 565,407 is budgeted as revenue (526.943 earmarked for foster care). Zero Countv dollars are budgeted for Economic Support/W-2, General Relief programs. Stephens suggested some of these items be placed in the budget, but segregated and made available only contingent upon Board approval. Sinclear stated you can't run a business (Sheltered Workshop) without putting dollars back into the business. Stephens stated increased revenues were utilized to improve the facility. Bethke stated air 2 conditioning should be installed at St. Croix Industries where they make the pallets. Best stated that area cannot be air-conditioned. There is too much saw dust. The filters would need to be changed daily. Horne questioned about the Network Server. Borup stated this would accommodate our increased automation needs, this is adequate per Kathryn Beutel. Computer Services. Horne asked how much more it would cost to upgrade even more at this time. We have already spent S 170.000 and want the upgrade to be enough. Borup will ask Beutel to check on this and get back to the Board. Nursing Home: Krieger stated that Medicare and Medicaid funds may decrease. Krieger stated the budgeted census in 1999 is 98. Horne stated the income from ITP is huge. It increased since we did not decertify beds. Horne stated without our ITP monies we will be in trouble. Horne asked whatever happened to the excess money we gave to pay off the nursing home. The nursing home should not have to budget interest. Krieger stated she spoke to Krizek and Krizek stated she should budget for the interest this year and next. Stephens stated we need to take this to the Finance Committee as we gave specific instructions to pay off the loan so there should be no interest. Horne stated the Cable TV was not a 1999 budget item. Borup stated this effects admissions as referrals bypass us because we don't have cable. Home Care: Merkt stated intake is down in general in home care throughout Wisconsin. The physicians are running a little scared as there is no concrete definition for home bound. Stephens stated Home Health has to give the care and then the State will decide whether they will pay for it. Merkt stated she has received a resignation from one of her nurses as the hours were cut. This 80 % position will be held open. Horne stated this budget is basically the same as last year's budget. Family & Children's: Borup stated the $70,000 is to contract foster care recruitment, retention, and training to increase the number of quality foster homes. This would help to reduce future costs of out of county placement. Johnson stated this would provide more options for kids. Stephens stated the loss of foster care to private vendors means we lose control of the budget and control of care. Dunlap stated the court mandates we keep the kids in the home school community, if possible. Horne stated he is convinced we need more foster homes. MOTION: A motion was introduced by Horne, seconded by Bethke, and unanimously adopted: That the Board place the $70,000 to contract foster care recruitment, retention, and training in the segregated fund until a plan is brought back to the Board. Contingency means the Health and Human Services Committee retains control of that money until administration comes back with a plan that is approved by the Health and Human Services Committee. Dunlap stated some of the W-2 profits are mandated for Family & Children's. Long Term Sport/St. Croix Industries: Lockwood reported that the expenditures proposed to purchase Day Services would meet the needs of adults with severe physical disabilities. These persons cannot be 3 served by St. Croix Industries because the space is not adequate to accommodate any more wheel chairs and because the staff lacks the expertise to serve persons with severe physical impairments. The lack of access to rest rooms will be corrected if the proposal to add automatic doors is approved. Mealey stated he attended a State Meeting in Madison and commended our Long Term Support Proizram%staff. He stated, "We have the top staff in the State,' and, "keep up the good work". Stephens asked if there is anyone on the waiting list that is hurting because they are not being seen. Lockwood stated the families are doing an adequate job, but that respite care is needed. There is a limited amount of respite available. The Day Activities Program is needed. St. Croix Industries provides respite for some. Lockwood said the Long Term Support budget for 1999 is only 4.8 % higher than the 1998 budget. The 7.6 % increase shown in the budget document was produced by a large increase in services purchased from St. Croix Industries by the Community Options Program and the Home & Community -Based Waiver Programs. Because the buyer and seller of services are programs entirely contained within the Long Term Suport Budget the expenses and revenues are doubled and artificially inflate budget changes. MOTION: A motion was introduced by Horne, seconded by Olson, and unanimously adopted: That the Board place the $29,615 for the new day services program in the department's contingency fund until a plan is brought back to the Board. This County cost results in total program revenues of $88,875 for day services. Mental Health: Dowd stated there have been several requests for a Mental Health Drop -In Center. Stephens stated he does not argue that this is not a good idea. In Tennessee, for example, this Drop -In Center is all they have. In Wisconsin, we already have a Mental Health Program with mandated services. Kiesler stated there is not enough information on this at this point and due to time limitation has not been researched enough. There is no formal proposal yet. Olson stated at the Open Hearing clients were fairly well orchestrated and should receive an appropriate response or recognition. Kiesler stated Eau Claire has a Drop -In Center, but St. Croix County does not have $50,000/year on an ongoing basis to fund this project. Kiesler stated he is at least six months away from getting a legitimate proposal. Borup and Kiesler intend for this to be a community project and would seek grant monies, community funds, etc. MOTION: A motion was introduced by Horne, seconded by Berenschot, and unanimously adopted: That the Board place the $50,000 for a mental health resource center in the department's contingency fund, until administration prepares a plan approved by the Health and Human Services Committee. Maintenance: 520.000 is needed for a BobCat in Maintenance. Bethke stated we need to purchase one. The one being used now is not safe and is used extensively. Stephens stated he would like to see the Center upgrade the BobCat, lawnmower, etc. every year for S500.00 like the Government Center does. We should be carrying that kind of investment that is covered by warrantee/year. The S500.00 would be the expenditure/year. Actual cost with trade-in is $10,000 split between Health and Human Services and the Nursing Home. 10 MOTION: A motion was introduced by Bethke, seconded by Dowd. and unanimously adopted: That the Board direct Maintenance to obtain specifications on a BobCat with a yearly trade-in like the Government Center and to purchase a BobCat now. Sinclear left the meeting. Public Health: Nelson stated Wisconsin ranks high for a healthy population. Olson questioned the Pregnancy Outreach Program. Nelson stated this program is to provide outreach to women eligible for medical services. Discussion on State reduction of immunization dollars. Horne questioned if the need was down. Nelson indicated it was not. Horne and Nelson also discussed the number of Public Health employees who work on a part time versus full time basis. Dowd left the meeting. Economic Support: Horne asked if W2 has made a profit. Fruit stated there are a lot of indefinites. Fruit stated the first 7 % and next level 10 % are not earmarked. 45 % must go into community investments for services included in State TANF (Temporary Assistance to Needy Families) Plan. Those are all the guidelines we have. Only 75 % of the preliminary distribution will be given to us. Horne stated one of the main reasons we went into W-2 was the profit potential. Fruit stated at the end of two years we will look at this program again. Fruit stated the amount in the budget is only a guesstimate, the State is saying they might give us the additional 10 % and 45 %. The 7 % is 7 % of the total allocation. The 10 % and 45 % are % of excess over expenditures. The preliminary 45 % will be approximately $200,000. Wisconsin Works (W-2) is the program Wisconsin uses to implement the TANF plan. In November we will look at the preliminary distribution. Horne stated use 7 % for the worst case and $200,000 for the best case. Home suggested Fruit write out the plan for the 45 % and figure on $300,000. The next contract will use performance criteria for the right of first selection. Olson asked about Badger Care. The Federal government has denied it but Fruit stated it will be implemented in November 1998 only to serve the children. The Budget summaries are as follows: The Health and Human Services Budget totals: Expenses Revenues Levy/Prior Year Carryover S16,887,764 $13,436,419 $3,451,345 ($2,982,910 County Allocation 468,435 Prior Year Carryover $3,451,345 TOTAL 9 Nursing Home - Based on Projected Census of 98: Expense Revenues County Levy S4,880,991 S4,880.991 - 0 - MO_: A motion was introduced by Berenschot, seconded by Bethke, and unanimously adopted: That the Health and Human Services Board approve the 1999 Budget County Allocation of S2,982,910 plus a prior year carryover of $468.435. with $194.615 (Bus Garage - $45,000; New Day Services Program - $29.615: Foster Care - $70.000: Mental Health Drop -In Center - $50,000) being segregated in the Budget and made available contingent upon Administration presentingplans Health and Human Services Board. that are approved by the The Nursing Home has a no county al Roll call vote: Robert Stephens - yes Leon Berenschot - yes Chris Bethke - yes Jack Dowd - absent Einar Horne - yes Fern Johnson - yes Allen Limberg - yes Mary Louis Olson - yes George Sinclear - absent Seven yes, zero no, two absent, motion passed. Gable TV for Nursing Home: The decision was made to proceed with the cable. Krieger was instructed to get the best deal she can get. The proposal for wiring/installation will be brought to the 09/11/98 meeting. Stephens asked if there were any other issues to bring before the Board. MOTION: A motion was introduced by Bethke, seconded by Olson, and unanimously adopted: That the Health and Human Services Board meeting be adjourned Time: 9:25 p.m. Chairman: Attest: Secretary 0